Abstract
Background: Diabetes increases the risk of Parkinson’s disease (PD). SGLT2 inhibitors show neuroprotective effects in animal models. Yet evidence is limited regarding the effect of SGLT2 inhibitors on PD risk. We thus aimed to assess the association between SGLT2 inhibitors and PD risk in T2D patients. Methods: In this retrospective cohort study, we used 2016-2020 national Medicare Claims data to identify beneficiaries with T2D and without preexisting PD. We compared the risk of PD between new users of SGLT2 inhibitors vs. DPP4 inhibitors. We employed 1:1 propensity score matching to balance the baseline confoundings between the treatment groups and applied Cox regression models to estimate the PD risk. Results: After 1:1 propensity score matching, 26,619 individuals were included in each of the two treatment groups, the PD incidence was 2.48 and 3.54 per 1000 person-years in the SGLT2 inhibitor group and DPP4 inhibitor group, respectively. In the Cox model (Figure), the SGLT2 inhibitor group was associated with a significantly lower risk of incident PD (HR 0.70 [95% CI 0.55-0.89]) than the DPP4 inhibitor group. The risk reduction of PD was particularly profound in non-Hispanic Black individuals (HR 0.24 [95% CI 0.07-0.86]) and insulin users (HR 0.49 [95% CI 0.32-0.77]). Conclusion: Compared to DPP4 inhibitors, SGLT2 inhibitors were associated with a significantly lower risk of indecent PD in people with T2D. Disclosure J. Guo: None. H. Tang: None. H. Shao: Consultant; Eli Lilly and Company. Y. Lu: None. L. Shi: None. V. Fonseca: Consultant; Abbott, Bayer Inc. Stock/Shareholder; BRAVO4HEALTH, LLC. Consultant; Corcept Therapeutics. Speaker's Bureau; Eli Lilly and Company. Research Support; Fractyl Health, Inc. Consultant; Sun Pharmaceutical Industries Ltd. Stock/Shareholder; Amgen Inc. Y. Guo: None. J. Bian: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK133465)
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